A surgical procedure wherein a passageway is formed through the skin, fascia and stomach wall and a tube installed in the passageway to allow nutrition to be provided directly into the stomach or intestines is known as a gastrostomy. A tube which is inserted through the passageway made during the surgical procedure to maintain the integrity of the passageway and convey fluids therethrough is known as a gastrostomy tube. Examples of individuals who would require such a procedure include: burn patients, whose daily caloric needs are very high; critically ill, weak or comatose patients who may be unable to chew their food; and patients suffering from a diseased or traumatized esophagus, who may be unable to swallow food.
The gastrostomy tube of the present invention is adapted for placement in a patient using the Sacks-Vine procedure, sometimes referred to as a "push" procedure. Briefly, this procedure entails the following steps: (a) passing an endoscope through the esophagus into the stomach; (b) locating a suitable site for the gastrostomy; (c) passing a Seldinger needle through the abdominal wall into the stomach, removing the inner stylet and leaving the cannula in place, then inserting a snare via the endoscope and looping the snare over the end of the cannula; (d) inserting a guidewire through the canula into the stomach, grasping the guidewire via the snare, and withdrawing the endoscope to deliver the guidewire through the mouth; (e) advancing the gastrostomy tube over the guidewire until the gastrostomy tube reaches the cannula and pushes the cannula through the abdominal wall; (f) gently pulling the gastrostomy tube through the abdominal wall until the internal retaining member of the tube engages the gastric mucosa; and (g) securing the gastrostomy tube in place by sliding a retention disc over the portion of the gastrostomy tube which now protrudes through the abdomen of the patient, and then cutting off the excess length of the gastrostomy tube. The Sacks-Vine procedure is well known, and has been described, for example, in the article "A CRITICAL ANALYSIS OF THE SACKS-VINE GASTROSTOMY TUBE: A REVIEW OF 120 CONSECUTIVE PROCEDURES", P. G. Foutch, et al., THE AMERICAN JOURNAL OF GASTROENTEROLOGY, August 1988, pp. 812-815, and books such as ATLAS OF NUTRITIONAL SUPPORT TECHNIQUES, John L. Rombeau, et al., Little Brown and Company, 1989, pp. 132-136.